Urapidil-induced increase of the intracranial pressure in head-trauma patients.

This report deals with two patients suffering from a closed head injury who demonstrated a rise of intracranial pressure (ICP) after bolus injections of urapidil to control arterial hypertension. The rapid fall of the arterial pressure was accompanied by an increase of ICP that amounted to approximately 50% to 100% of the initial values (and thereby reaching ICP values between 32.5 and 40 mmHg); cerebral perfusion pressure decreased to less than 50 mmHg, and nearly reached control values at 15 min after administration of urapidil. The mechanism for this ICP rise is unknown and remains speculative. So far, no other clinical or experimental data are known to us reporting a urapidil induced increase of ICP in head trauma patients.